Fibromyalgia: Teeth & Jaw Pain

People who have fibromyalgia hurt all over. The pain often extends into their teeth and jaws, leading patients to believe they may need a filling or root canal. Researchers have concluded, however, that tooth and jaw pain isn't always a sign of a dental problem and may be associated with fibromyalgia.

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Fibromyalgia is a syndrome, rather than a disease. In addition to widespread pain in the muscles and tendons, sufferers may experience sleep disturbances, fatigue and trouble concentrating. Patients sometimes have overlapping conditions such as irritable bowel syndrome, interstitial cystitis, depression, lupus and rheumatoid arthritis. No one is sure what causes fibromyalgia, but researchers believe injury, trauma or viruses may play a role.

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The temporomandibular joint (TMJ) is located on each side of the head. This joint, along with the lower jaw and the jaw muscles, makes it possible to open and close the mouth.

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There are two types of disorders of the temporomandibular joint disorder (TMJD). Joint TMJD is caused by damage to the cartilage or ligaments of the joint. Patients with joint TMJD may suffer from popping and clicking of the jaw joint and the inability to open the mouth very wide. According to the American Dental Association, joint TMJD may result from arthritis, injury or dislocation. The second type of TMJD is muscular and is more likely to affect fibromyalgia patients. Muscular TMJD affects the muscles used to chew and move the face, neck and shoulders. Lack of sleep, stress and muscular trauma may cause muscular TMJD.

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Mark Borigini, M.D., a board-certified rheumatologist at the University of California-Irvine School of Medicine, says in an article in Psychology Today that doctors, dentists and patients don't always discuss pain in the face or teeth because they believe it isn't related to fibromyalgia. Since TMJD sometimes causes headaches, nausea and dizziness in addition to dental symptoms, doctors and dentists have a difficult time diagnosing it.

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Properly caring for TMJD can be difficult. Insurance companies are often reluctant to pay for TMJD because of the controversy over the causes of and treatments for TMJD. Borigini says there also isn’t a great deal of scientific validation for TMJD treatments.

Once dental decay or abscess is ruled out, patients must get their stress under control, Borigini says. Massage, as well as lifestyle changes or medications may help relax the facial muscles and relieve the pain and sleeplessness of TMJD. Patients with tooth alignment problems need dental intervention. Doctors and dentists may also have to coordinate the patient’s care and talk with insurance companies about the necessity of treatments.